We spend a lot of time putting together metrics that track what's happening in the sectors of the health and human service field serving the most complex consumers. Over just the past year, our team has found that:

An estimated 4.8 million consumers with SMI are enrolled in Medicaid

More than 163.8 million people suffer from the five most costly chronic conditions: mental disorders, heart conditions, diabetes mellitus, cancer, and COPD/asthma

Projected spending on child and family services in 2017 is $381.1 billion

37 state Medicaid programs have integrated physical and behavioral health financing; 11 state Medicaid programs have a behavioral health carve-out to a care management organization

Spending on behavioral health services is an estimated $253.8 billion in 2017 and spending is growing at a faster rate than general health care

But unless you're putting together the details on these numbers, it isn't apparent how bad the state of market metrics is in the health and human service space. Read more here.

Local governments pressing lawsuits to hold pharmaceutical companies responsible for the opioid epidemic told a judge that taking the strongest version of Purdue Pharma Inc.'s Oxycontin painkiller off the market would have immediate results in addressing the crisis, according to people at the meeting.

Purdue's 80-milligram version of Oxycontin is snorted by thousands of abusers, so removing it would be a good first step, experts for cities and counties and state attorneys general told U.S. District Judge Dan Polster, according to three people in attendance at the Wednesday meeting. They spoke on the condition of anonymity because they weren't authorized to speak publicly about the closed-door summit.

Polster is overseeing more than 200 suits filed by U.S. cities and counties seeking to recoup the costs of dealing with opioid addictions and overdoses in a Big Tobacco-style accord of 1998. The judge has said he wants a deal that goes further than money to also address business practices and the roots of the crisis. Read more here.

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422

How Much Is the Opioid Crisis Costing Governments?

Anyone who's familiar with addiction knows that it's insidious: It sneakily takes hold until the addict suddenly doesn't recognize his life anymore. Paying for addiction is like that, too.

"The costs build up slowly over time, so you almost don't even notice it," says Mark Chalos, a Nashville-based partner at Lieff Cabraser Heimann & Bernstein LLP, a law firm counseling counties considering

opioid-related lawsuits. "But when our people really started to dig into the budgets, they realized the costs are more significant."

Of course, there are the easier costs to quantify. For example, Pennsylvania estimates it is spending $5 million a year on the overdose-reversal drug naloxone. And in Middletown, Ohio, City Councilman Dan Picard estimates that each ambulance run for an overdose costs the city $1,140, which includes the cost of naloxone and wear-and-tear on the ambulance. From October 2016 to October 2017, Middletown answered 916 overdose calls, taking more than $1 million out of its $30 million annual budget. Read morehere.

New York Accuses Insys of Deceptively Marketing Opioid

Insys Therapeutics Inc's legal woes deepened on Thursday as New York's attorney general filed a lawsuit seeking at least $75 million from the company, which he said deceptively promoted a fentanyl-based cancer pain medicine for unsafe uses.

New York Attorney General Eric Schneiderman alleged that the Chandler, Arizona-based drugmaker recklessly marketed its product Subsys for wider uses than the U.S. Food and Drug Administration approved and bribed doctors to prescribe it.

"At a time when the opioid epidemic was ravaging New York, Insys Therapeutics allegedly marketed a drug illegally by blatantly disregarding the grave risks of addiction and death that opioids pose," Schneiderman said in a statement.

Insys said it sought to address the challenge related to the misuse and abuse of opioids that has led to addiction and unnecessary deaths around the country. Read morehere.

2018 PPS Tier 1 CBO Survey Results

The results from the 2018 Performing Provider System (PPS) Tier 1 Community Based Organization (CBO) Surveys have been posted to the DOH website here.

PPS were asked to complete the survey to provide updated information regarding contracting with organizations meeting the Tier 1 definition of a CBO as put forth by the NYS Value-Based Payment Workgroup on Social Determinants and CBOs, which is: Non-profit, Non-Medicaid Billing, community-based social and human service organizations (e.g. housing, social services, religious organizations, food banks).

The survey includes 1st level distribution of funds to CBOs (PPS-to-CBO funds flow) and 2nd level distribution of funds to CBOs (PPS to "hubs" or other contracted entities that then contract and/or distribute funds to CBOs) for DSRIP purposes.

Another Drug Worrying Authorities

Law enforcement is keeping an alert eye out for yet another drug to hit the streets. It's called kratom. It comes from the leaf of a plant grown in Asia, where it's been used for years as a mild stimulant. However, in larger doses, it acts as an opioid. That's what has police and the medical community on edge.

It's legal right now, but that could change.

"If you go too high in the dose, then the opiate becomes very, very much enhanced and it would be like overdosing on an opiate," explained Dr. Jeffrey Fudin.

That's just one of the problems with kratom, says Fudin, a clinical pharmacology specialist at the Stratton VA Medical Center. He says it can interact with other drugs and cause agitation, heart attack and stroke. Read morehere.

Governor Andrew M. Cuomo this week announced a 30-day budget amendment will be advanced to add 11 fentanyl analogs to the state controlled substances schedule and provide the New York State Health Commissioner the authority to add any new drugs that have been added to the federal schedule, to the state controlled substances schedule. These actions will support law enforcement in their efforts to stop the spread of lethal drugs in New York State.

In recent years, fentanyl analogs have been increasingly found pressed into pill form to resemble name-brand prescription opioids, and in heroin and cocaine being sold in New York State. Compared to 30 milligrams of heroin, just three milligrams of fentanyl can be fatal. A preliminary analysis conducted by the Department of Health identified more than 2,900 opioid-related deaths among state residents in 2016. Specifically, Staten Island saw a 700 percent increase in overdose deaths involving fentanyl - from seven deaths in 2015 to 58 deaths in 2016. Statewide, the number of fentanyl-related deaths increased by nearly 160 percent. Read more here.

Governor Cuomo Announces 30-Day Budget Amendment to Ban Sales of Synthetic Marijuana Across New York State

Governor Andrew M. Cuomo this week announced a 30-day budget amendment will be advanced to add 36 different chemical compositions to the state's controlled substances list. The 36 compounds, commonly referred to as K2, are already listed on the federal schedule of controlled substances but are only banned in certain New York State counties. This action will ensure manufactures and sellers in every one of New York's counties are subject to the same criminal penalties.

Under current law, in several counties across the state, an owner of an establishment, as well as any other person possessing, distributing, selling or offering prohibited synthetic marijuana for sale, will face a fine up to $500 and/or up to 15 days in jail. Civil penalties can also carry a fine up to $2,000 per violation. Currently penalties are not uniform and are permitting this public health threat to continue.

This budget amendment builds on New York's aggressive efforts to crack down on the illegal sale of K2. Read morehere.

As the state moves more of its Medicaid spending into payments that reward high-quality providers, a new program aims to accelerate progress on the behavioral-health side.

The state is investing $60 million over the next three years through the Behavioral Health Value Based Payment Readiness program to get more providers up to speed.

Until now most of the state's efforts have focused on physical health. Preparing the behavioral-health industryfor payment reform will be an integral part of the state Medicaid program's goal for managed-care organizations to spend at least half of their funds through value-based payments by April 2019. Annual Medicaid spending on behavioral-health conditions is about $7 billion, according to Medicaid Director Jason Helgerson.

"This is the future. This is coming," Helgerson said at the Coalition for Behavioral Health's annual conferencelast week in Manhattan. "It's not time to bury one's head in the sand and try to resist change at all costs." Read morehere.

Pew Charitable Trusts: Jails - Inadvertent Health Care Providers

Every year, millions of people are booked into U.S. jails. During 2015, the latest year for which data are available, there were 10.9 million admissions to these correctional facilities, which hold individuals who are awaiting trial or serving short sentences. The government running the jail-usually a county-has a constitutional mandate to provide people booked into these facilities with necessary health care. Counties designing a jail health care program targeted to meet the needs of their incarcerated population have the opportunity to improve the health of people in jail and the broader community, spend public dollars more effectively, and, in some cases, reduce recidivism.

Yet little is known about how jails administer their health care programs and whether these programs further county public health and safety goals. Research is limited on how counties organize their jail health care services, what care they make available and when, and how they ensure they receive value for their investment in health care. Despite growing awareness of the connection between community services for recently released individuals-especially those with mental illness or substance use disorders, collectively known as behavioral health disorders-and a reduction in recidivism, information about how to achieve this result is scarce. Read more here.

The Conference of Local Mental Hygiene Directors advances public policies and awareness for people with mental illness, chemical dependency and developmental disabilities. We are a statewide membership organization that consists of the Commissioner/ Director of each of the state's 57 county mental hygiene departments and the mental hygiene department of the City of New York.Affiliated